Pediatric Epilepsy Syndromes 07

Topic: Pediatric

A 12 year old girl presents after having a generalized tonic-clonic seizure. She has noticed that, when she brushes her teeth or combs her hair in the morning, she occasionally experiences a brief, involuntary jerk in her upper extremities. Past medical history is otherwise unremarkable. There is no family history of seizures. Exam is normal. You obtain an EEG, which reveals occasional generalized bilateral polyspikes and spike wave complexes at 5Hz.

Of the following options, which agent is the best choice as a first-line monotherapy treatment?

This question was created on October 04, 2007 by jdmiles.This question was last modified on October 04, 2007.

ANSWERS AND EXPLANATIONS

A) Valproate

This answer is correct.

This child has juvenile myoclonic epilepsy. Valproate is considered the initial treatment of choice. Lamotrigine and topiramate, while not approved by the FDA for this use, are also commonly used as initial monotherapy. (See References)